Home – Surgery #4 Update

“It is so nice to be home!”   These were the first words Zack said when he walked through the door.   He also sang the words from the movie Bolt, “There is no home like the one you got, cuz that home belongs to you!”  We could not agree more.

Zachary’s surgeon is very pleased with the outcome of the surgery.  For those of you who like the medical details, here they are in my non-medical words…

Once Z was sedated, the team opened up a small portion of his “zipper”.  That’s what they call the mid-line incision they made 2 surgeries ago and have used again both in October and then again on Wednesday.  Happily, this time they only had to open a little section of the bottom under his navel.  Skipping to the end for a moment, when they closed him up, they did it from the inside, so you cannot see any sutures.  I think that is pretty cool.

His doctor was hopeful that he would be able to visualize what he needed to see without using a camera, but in the end had to make another small incision a little bit more than an inch above the zipper and to the left to allow the camera into the abdomen.  Once inside, they were happy to find that Zack had no scarring.  This amazes us as it is his fourth abdominal surgery.  It is great news as we approach our reattachment surgery in the near future.

The surgeon then pushed Zack’s stoma back inside his body.  He used his “tools” (I could not even begin to guess what he used) to scrape the abdominal wall with the hope that roughing up the area would allow it to scar easier and thus help the bowel to adhere quicker.  One of the many reasons I am glad he is the surgeon.

Next, the surgeon used absorbable sutures to take little tiny “bites” from the outer layer of Zack’s intestines and tacked them to the roughed up abdominal wall.  Our surgeon’s resident explained that there is no way to attach the last little bit of the intestine next to the stoma opening, but the next ten(ish) cm are tacked down.  Jim and I have to remember to tell any surgeons who work on Zack, besides our current one, that his intestines are right beneath his zipper so that they are not accidentally punctured.  No pressure parents….

Our Zack now has a track record for not feeling well when he wakes up from abdominal surgery.  It seems like it takes his body just a little longer to get used to the discomfort.  As a result, we ended up staying at Walter Reed one extra night.  I appreciated not having to go home while he was still in so much pain.  By this morning, however, it was clear it was time to get out of there.

Last night we began to notice the stoma was “bulging”.  This did not give us warm fuzzy happy feelings.  Our surgical resident came up and said that it is probably the last little bit of bowel that could not be attached to the abdomen trying to protrude.  We discussed this with our surgeon this morning and he said we should remain optimistic and that whatever is going to happen will be OK.  This procedure is/was intended to help buy us time, but if we don’t get as much as we hoped, things will still be alright.  AND we might get the time we hoped..this bulge could be all that happens.

We are hopeful that is the case.  This experience has left us a little cautious, however.  By this experience, I mean since the beginning of Zack’s surgeries back in June.  Having an ileus, then obstructing, then prolapsing.  All of it.  It is sometimes hard to find optimism when the fear of another complication is always lurking.  We are determined to be optimistic and so I frequently find myself pushing the negative thoughts away.

Always a planner, I have spoken to both Zack’s surgeon and GI and asked them what their plans are “IF” this does not work.  They all know my concerns and they have discussed different options with me.  Now that I know they have an idea of what they would do next if necessary, I can go back to focusing on the positive.

Our game plan for the next two weeks is to keep Zack quiet.  If you know Zack, you will know this is not easy.  No lifting, no running, no rough play, just plain old walking.  The hope is that by keeping him quiet, the sutures will have a chance to really stick.  We plan on keeping Zack home from school next week.  The week after we hope that he will attend 1/2 days and then after our surgical review we hope he can go back to being “Regular Old Zachary.”

That, my friends, is the quickest update I can pull together.  Tomorrow is a big day around here.  Our son, Jake, is in a play called The Trench and tomorrow is a special performance at the Carroll Arts Center in Westminster, MD.  Jake has composed some of the music in the play and we can’t wait to see it.  Jake’s school is competing in the Maryland State Thespian Festival with this play and tomorrow’s performance is their chance to perform in front of a live audience before the competition.  After the festival, they will be performing the show at their school for all to see.  I’m off to go and see this other child of mine.  I sure miss him while I’m at the hospital with Zack.

Thank you for all of your well wishes, prayers and phone calls while Zack was in the hospital.  As always, the support of others helps make difficult times less stinky.  I’m so good with words.  Tomorrow, the birthday update!  Happy Friday!

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